PEER CONNECT: a pragmatic feasibility randomised controlled trial of peer coaching for adults with long-term conditions

同伴互助:一项针对长期疾病成年人的同伴辅导实用可行性随机对照试验

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Abstract

OBJECTIVE: To test the feasibility of a targeted peer coaching intervention on the health and well-being of people with long-term health conditions and low activation attending outpatient clinics at a UK National Health Service (NHS) Trust. DESIGN: Randomised controlled feasibility trial, with embedded qualitative study. SETTING: An NHS integrated health and care organisation in the South West of England, UK, with significant areas of deprivation. PARTICIPANTS: Patients (over 18 year of age) of the Trust's rheumatology, pain or multiple sclerosis services, with a Patient Activation Measure score at level 1 or 2. INTERVENTION: Up to 14 sessions of peer coaching delivered in a stepped-down model delivered over 6 months. MAIN OUTCOMES: Primary feasibility outcomes were recruitment, retention, intervention adherence and peer, coach and staff experience.Secondary outcomes included psychological well-being, resource use, long-term condition management and disease-specific measures. RESULTS: 97 potential coaches were contacted directly. 27 (27.8%) were screened and of those 21 (77.8%) were eligible and recruited into the study. For a range of reasons, only five (23.8%) progressed through training and on to deliver peer coaching. 747 potential peers were invited to take part and 19 (2.5%) were screened. Of those screened, seven (36.8%) were eligible, recruited and randomised, all white females with median age of 50 years (range: 24-82 years). One peer in the intervention group withdrew prior to receiving the intervention, the remaining four received coaching. Peers and coaches reported a range of benefits related to their health and well-being. CONCLUSION: Coach recruitment, training and study procedures were feasible and acceptable. Due to low peer recruitment numbers, it was decided not to progress to a definitive trial. Further research is required to explore how to engage with and recruit people reporting low levels of activation and the acceptability and effectiveness of peer coaching for this group. TRIAL REGISTRATION NUMBER: ISRCTN12623577.

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